2 results
Varicella zoster virus outbreak in a long-term care unit of a tertiary care hospital in northern India
- Rushika Saksena, Bonnie J. Thomas, Ruma Das, Sunita Nagpal, Prem R. Suri, Ranjan K. Wadhwa, Aashish Choudhary, Rajni Gaind, Ekta Gupta
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- Journal:
- Epidemiology & Infection / Volume 152 / 2024
- Published online by Cambridge University Press:
- 13 May 2024, e81
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Nosocomial outbreak of varicella zoster virus (VZV) has been reported when susceptible individuals encounter a case of chicken pox or shingles. A suspected VZV outbreak was investigated in a 50-bedded in-patient facility of Physical Medicine and Rehabilitation in a tertiary care multispecialty hospital. A 30-year-old female patient admitted with Pott’s spine was clinically diagnosed with chicken pox on 31 December 2022. The following week, four more cases were identified in the same ward. All cases were diagnosed as laboratory-confirmed varicella zoster infection by PCR. Primary case was a housekeeping staff who was clinically diagnosed with chicken pox 3 weeks prior (9 December 2022). He returned to work on eighth day of infection (17 December 2022) after apparent clinical recovery but before the lesions had crusted over. Thirty-one HCWs were identified as contacts a and three had no evidence of immunity. Two of these susceptible HCWs had onset of chickenpox shortly after first dose of VZV vaccination was inoculated. All cases recovered after treatment with no reported complications. VZV infection is highly contagious in healthcare settings with susceptible populations. Prompt identification of cases and implementation of infection prevention and control measures like patient isolation and vaccination are essential for the containment of outbreaks.
Surveillance of Healthcare-Associated Bloodstream and Urinary Tract Infections in a National Level Network of Indian Hospitals
- Purva Mathur, Paul Malpiedi, Kamini Walia, Rajesh Malhotra, Padmini Srikantiah, Omika Katoch, Sonal Katyal, Surbhi Khurana, Mahesh Chandra Misra, Sunil Gupta, Subodh Kumar, Sushma Sagar, Naveet Vig, Pramod Garg, Arti Kapil, Manoj Sahu, Arunaloke Chakrabarti, Pallab Ray, Manisha Biswal, Neelam Taneja, Priscilla Rupali, Vellore Binila Chacko, Joy Sarojini Michael, Veeraraghavan Balaji, Camilla Rodrigues, Vijaya Lakshmi Nag, Vibhor Tak, Vimala Venkatesh, Chiranjay Mukhopadhyay, KE Vandana, Muralidhar Varma, Vijayshri Deotale, Ruchita Attal, Kanne Padmaja, Chand Wattal, Neeraj Goel, Sanjay Bhattacharya, Tadepalli Karuna, Saurabh Saigal, Bijayini Behera, Sanjeev Singh, MA Thirunarayan, Reema Nath, Raja Ray, Sujata Baveja, Mammen Chandy, Sudipta Mukherjee, Manas Roy, Gaurav Goel, Swagata Tripathy, Satyajeet Misra, Anupam Dey, Tushar Mishra, Hirak Raj, Bashir Fomda, Gulnaz Bashir, Shaista Nazir, Sulochana Devi, Khuraijam Ranjana Devi, Langpoklakpam Chaoba Singh, Padma Das, Anudita Bhargava, Ujjwala Gaikwad, Neeta Khandelwal, Geeta Vaghela, Tanvi Sukharamwala, Prachi Verma, Mamta Lamba, Shristi Jain, Prithwis Bhattacharyya, Anil Phukan, Clarissa Lyngdoh, Rajeev Sharma, Rajni Gaind, Rushika Saksena, Lata Kapoor, Neil Gupta, Aditya Sharma, Daniel VanderEnde, Anoop Velayudhan, Valan Siromany, Kayla Laserson, Randeep Guleria
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s398-s399
- Print publication:
- October 2020
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Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.
Funding: None
Disclosures: None